Researchers from Columbia University Medical Center, New York, the United States in collaboration with the NBA have found that the physical training program of the NBA was the root problem for the increased risk of heart diseases after retirement. Even though doctors in the NBA know the development of heart diseases in some players with the NBA training program, they failed in identifying the players who are at a high risk of heart diseases.

The researchers have found that the intense training of the NBA is causing the physical changes in the heart, especially in the physically large player. It is very difficult for a doctor to determine whether the heart of a player is athletic or abnormal. There are no specific heart health guidelines for the NBA athletes. But researchers say that the current guidelines are not useful to Black NBA athletes as those guidelines were not created with a focus on them.

NBA-affiliated physicians have done a two-year long study. They have collected data related to stress echocardiogram (also called as stress echo or echocardiography stress test) and electrocardiograph (ECG) on 519 NBA players and draft prospects. The average age of the study participants was 24.8 years. About 78.8 percent of the players are African American (Black). This information has helped the physicians in investigating the abnormalities in the size, shape and functioning of the heart associated with the training program of the NBA.

The researchers have found that about 89 percent (or 462) of the athletes have the physiologic and ECG changes due to the training. The current heart health guidelines do not account for these abnormal ECG results.

They also found likely ECG abnormalities in the NBA players aged between 27 and 39 years compared to the NBA players aged between 18 and 22 years. The abnormal ECG were found to be 11.4 percent in the African American athletes when compared to 5.3 percent in the White athletes even after multiple changes in the ECG interpretation.

As the current guidelines were prepared with the White athletes in mind, the NBA-affiliated physicians were unable to identify a player with a heart problem due to the physical training program of NBA.

The authors say that even though all ethnic groups have common risk factors for heart health, there is a small difference in the heart of a Black (African American) athlete compared to a White athlete. The authors suggest other criteria for the evaluation of future risk of heart attack, mortality or death in the African American or Black athletes. Review of heart health criteria for the NBA basketball players is important to prevent the false positives in the African American (Black) athletes.

Authors also say that there is a need to conduct an investigation with a larger cohort of Black or African American athletes in preparing the ECG guidelines (normal/abnormal ECG) and for developing the diagnostic tests which can help in predicting the risk of heart disease, mortality or death in them.

The author of the investigation was Dr. Marc P. Waase, MD, Ph.D., electrophysiology fellow at Columbia University Medical Center, New York, the United States. The study was published December 6, 2017, in the JAMA Cardiology. Title of the article was "Electrocardiographic Findings in National Basketball Association Athletes." DOI: dx.doi.org/10.1001/jamacardio.2017.4572

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